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[SueLW]

Some examples of terrible help on this thread.

My GP admitted to knowing nothing about menopause and HRT so I started with the Marion Gluck clinic.  It's very expensive.  I tried all the preparations.  Lozenges, creams, patches etc.  I felt pretty awful most of the time, I sort of just didn't realise it.  And chopping and changing the medications and all the blood tests mounted up and up in price.  Then the doctor I saw left and set up on her own.  I followed her and still never felt right and every visit seemed to result in a change and a belittling lecture about weight and diet and exercise.  Finally, in summer, I told her I wanted to try Estrogel and Utrogestan.  She agreed and prescribed just 1 pump a day of the gel even though for years she had been telling me my body just ate up the oestrogen or didn't absorb it because my levels were so low.  After a week on one pump I felt just as horrible so I upped it to 2 pumps and started to feel better.  I was using Utrogestan vaginally every other day. 

But I was lucky and managed to get a cancellation appointment with menopause specialist Dr Louise Newson. Boy was that a different experience.  She is understanding and sympathetic.  And I believe she and her 2 fellow doctors know what they are doing.  No compounded products from her, just NHS products dosed properly and Australian testosterone cream because it's the only testosterone made for and licensed for use in women!. 

She understands the terrible state of menopause care in the UK and is working hard to make a difference running training courses for GP's, nurses and other medical professionals and having a pretty well stocked information section on her web site.  She ran an open day recently that was a resounding success. 

When I saw her she listened and asked questions and then said I wasn't on enough gel and that I could adjust up to 4 pumps a day.  I am now on 3.5.  I think I need 4 but I'm spotting a lot at the moment even though I have gone up to using the Utrogestan every night vaginally.  I get no side effects from it that way other than the spotting, but when I tried using 2 capsules one night I was incredibly tired the next day.  Given that I have thyroid issues leaving me exhausted almost permanently, I can't take something that makes me even more tired.  I'm due a review appointment in early December and will talk to her about options for that problem then. 

I'm battling a thyroid problem that isn't responsive to normal NHS Levothyroxine so that's making things harder.  But I can honestly say I feel so much better hormonally since seeing Dr Newson.  She and her new clinic is definitely one to watch.

[Nik2502]

I have no sex drive whatsoever. Might as well be dead from the waist down! Poor hubby. It's been two years now :-( x

[CLKD]

  SueLW

Nik - lay back and think of England.  Guilt ate me up and eventually, my sexual drive kicked back in  = no guilt.

[Hurdity]

I'm sorry you feel so down.
 You need a meno specialist not a gynaecologist. But before you think of seeing anyone else it might be wise to do some research. Because there isn't a testosterone product that's licensed for women in the UK whoever prescribes it is responsible for your safety. It might be that there's a good reason she won't prescribe it to someone with a high BMI, it might be more dangerous for you than for others. If it is you may have to accept you either don't have it or reduce your BMI. If it isn't you can argue your case and she can explain WHY she won't prescribe it, and at least you'd have a chance of someone else prescribing it.
  You say your life is flat and joyless. I'm not sure if testosterone will fix that. For me it has helped libido (from zero to very low, nothing like what it used to be), stamina and muscle strength (used to pull them frequently). Mood was helped by oestrogen. 
 Not all meno specialists will prescribe testosterone (to anybody) so do ask questions before you spend any more money.

Great post sheila99

Nik2502 - High BMI of itself is not a contra-indication to HRT but depending on your age and where in menopause you may be at greater risk from stroke etc - depending on your general health and other risk factors eg BP and cholesterol, whether you smoke, exercise well, diet etc. However transdermal HRT is not associated with greater stroke risk so you should be able to be prescribed this - if no other contra-indication and depending where in menopause you are, and what your natural periods are doing?

You would not want to have tesosterone without oestrogen anyway as you could tip the balance to become T dominant and then may get androgenic sdie effects.

If you are on other medication - this can also depress libido eg some ADs and others. Oral HRT also can depress libido so transdermal ( patches or gel) would also be the way to go.

You could argue that once you have improved your menopausal symptoms ( flushes and sweats? Mood?), you will be in a better position to take positive steps to reduce your BMI which of course is desirable for your long term health.

Not sure if this has been mentioned but have you also had your thyroid function checked? Many women put on weight at this point in their life due to slowing of the metabolism but also some women like SueLW as she has said - develop underactive thyroid which increases weight gain and is very poorly recognised and treated.

Hope you find a solution!

Hurdity x